Dr. Tomi Gomory and his co-authors Stuart Kirk and David Cohen published their book Mad Science: Psychiatric Coercion, Diagnosis, and Drugs in April 2013 (published by Transaction Publishers).  The book has added its voice to a number of critics surrounding the Diagnostic Statistic Manual (DSM) and has received quite a bit of attention, appearing in USA Today on May 13, 2013 (Section 4D).  Dr. Gomory, an associate professor at the Florida State University College of Social Work agreed to discuss his latest publication and it’s special significance surrounding the DSM and its latest revisions and the challenges confronting the field of mental health.

What is the key point, or points, you wished to address in your book?

DR. GOMORY: The book essentially takes a critical look at the entire field of psychiatry,  from its inception as a formal medical specialty assumed to have special competence over madness and argues using the latest rigorous research available that its fundamental character is unscientific and it is a pseudo-medical profession. We found for example that  its use of coercion is the only long-term consistent treatment that it has employed, the other “treatments” used dependent on the latest theoretical fashions or fads include confinement in locked facilities, physical restraint, lobotomy, electroshock, stupefying and energizing psychoactive drugs and talking therapy.. Our analysis of the DSM’s diagnostic approach, demonstrates that it uses arbitrary conceptual diagnostic labels that have no reliability and as a result no real world validity, an analysis now recognized by the National Institute of Mental Health on its website along with most scientific experts interested in the topic. And finally, we look at psychotropic medication. These really are a subset of a wide array of psychoactive chemicals that turn out not to target any specific illnesses but are generic and general behavioral change agents that anyone taking them, diagnosed or “normal” (assuming equal dosages) react to identically. Their behavior and mood states will become hyperactive/elevated or suppressed/depressed.

Are there other books on this topic? If yes, what is new or different in your book?

DR. GOMORY: There are many critical books especially now since the DSM-5 is coming out. What is special about ours is that not a single other book, does what we do, which is to take the entire history of psychiatry and its use of language to shape our ideas about madness and critique it. We also evaluate psychiatric treatment combined with our close look at drugs and the role of diagnosis. The general trend in the critical literature is to talk about either drugs or diagnosis. They leave out the whole arena of whether psychiatry is a legitimate scientific field of practice. Based on our review of the scientific literature we believe that it isn’t and further we think psychiatry does not do justice to the problems of those who are severely troubled or troubling because those issues are not medical problems, but are something far more complicated,  a complex of of  psychological-social-ethical-moral and existential difficulties.

Is this book targeted at any population in particular?

DR. GOMORY: Well, we’re hoping that it is broader than most academic books in that it will engage anyone and everyone who is interested in the area of deviance, troubling behavior, so-called mental illnesses. So the intelligent lay reader along with scholars and educators would be whom we target. The book is of course useful for any academic course that addresses the field of mental disorders, mental illness, deviance and psychopathology.

What is the central theme do you hope to convey to someone reading this book?

DR. GOMORY: Well, the main take away is that we for the last sixty years have gone in the wrong direction in trying to help troubling and troubled people. We have completely missed the problem and how to deal with it. And so, we are hoping that it will help stimulate a serious review of the scientific literature and promote a debate about our current mental health practices, but this is a difficult agenda because the use of psychiatric drugs is such a major part of the whole psychiatric enterprise. It happens to be somewhere between a ten and twenty billion dollar a year business. So pharmaceutical companies, which are one of the most politically influential lobbies in Washington are committed out of self interest to keeping the idea of madness as a medical problem institutionalized, Politics unfortunately plays a major role in shaping our thinking in this area.

Could you speak a little about the process of writing the book?

DR. GOMORY: Originally I had this idea…I was troubled by psychiatry and the way that we’re dealing with those defined as mentally ill based on my own work. And of course in social work we are supposed to be committed to what we call psychosocial treatment, that is, talking and promoting and sustaining various activities with people. But in fact, it turns out that we are completely and unfortunately mostly uncritically committed to the DSM.  We treat it like the “Psychiatric Bible” that it’s called. And so this has troubled me for many years. Two of my social work colleagues, Stuart Kirk from UCLA and David Cohen from Florida International University are good friends of mine, so I broached the idea of combining our critical faculties and areas of expertise to write this book.. This was back in 2004, I want to say. And, we got enthusiastic. It originally started out as a series of chapters summarizing our old articles. But, over time we realized that there was so much new to add, and there was so much that hasn’t been published before, and our own ideas have evolved over time that we decided to make it this very flowing kind of work. As a result we spent eight years of our lives, I think the happiest years of my life in academia, working on it. We were fortunate enough to meet three or four times regularly at some of the greatest cities in the world to catch up and edit our work.

To reach Dr. Gomory directly, contact him at tgomory@fsu.edu.

He is an Associate Professor and Fulbright Scholar at the College of Social Work, Florida State University specializing in Mental Health, Homelessness, Social Work Education, and International Social Work.

Check out Mad Science: Psychiatric Coercion, Diagnosis and Drugs online.